Numerous surgical periodontal techniques have been introduced, over the years, to correct
labial, gingival recessions defects. Aesthetic concerns are usually the reason to perform
these procedures. The aim of this project was to evaluate by means of an image analysis
system the efficacy of two different surgical procedures with and without the use of a subepithelial
connective tissue graft for the treatment of miller class one and two maxillary
gingival recession. Therefore the aim of the first study was to compare the effectiveness of
root coverage with coronally advanced flap alone versus a connective tissue graft used in
combination with a coronally advanced flap in the treatment of single gingival recessions
by analyzing the data with an open source image-processing program.
The result of this study showed better outcomes in terms of recession reduction after 12
months when the coronally advanced flap was combined with the connective tissue graft.
Adjunctive application of a connective tissue graft under a coronally advanced flap
increased the probability of achieving complete root coverage in maxillary Miller Class I
and II defects (61.5% vs. 83.3%, p=0.38). The second article is a case demonstration of the
benefit attained using the CAF+CTG in order to meet the patient’s needs and fulfilling the
clinical outcomes.
More recently, several authors have proposed the application of a connective tissue graft
using a tunneling technique, which has recently gained popularity in periodontal
mucogingival therapy. However, there is scarce data available regarding postoperative
patient-centered outcomes after tunneling technique as compared to other surgical
procedures for the treatment of gingival recession. The aim of the second randomizedcontrolled
clinical trial was to compare the patient morbidity and root coverage outcomes
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of a connective tissue graft used in combination with a coronally advanced flap or tunneling
technique.
Fifty patients completed the study. Healing was uneventful for all test and control patients.
The connective tissue graft used in combination with a coronally advanced flap group
reported less pain or discomfort in all four sections of the questionnaire: Pain experienced
within the mouth as a whole, pain experienced throughout the day, pain experienced at
night and edema experienced after the surgery (p=0.002, p=0.001, p=0.001 and p=0,001,
respectively). Both treatments showed clinical efficacy in terms of root coverage as no
differences per groups were observed in percentage of root coverage (87% vs. 85%, p=704)
or patients with complete root coverage (60% vs. 52%, p=0.569).
The tunneling technique is associated with a greater incidence of pain and discomfort
compared to the connective tissue graft used in combination with a coronally advanced flap
in early postoperative periods, as well as longer chair time. Both treatments showed similar
clinical efficacy in terms of root coverage.
The results of this study may influence the surgeon’s choice on which root coverage
procedure perform considering the need of more chair time and more pain killer assumption
with the tunnel technique.
| Identifer | oai:union.ndltd.org:TDX_UIC/oai:www.tdx.cat:10803/387224 |
| Date | 30 June 2016 |
| Creators | Gobbato, Luca |
| Contributors | Nart Molina, José, Universitat Internacional de Catalunya. Departament d'Odontologia |
| Publisher | Universitat Internacional de Catalunya |
| Source Sets | Universitat Internacional de Catalunya |
| Language | English |
| Detected Language | English |
| Type | info:eu-repo/semantics/doctoralThesis, info:eu-repo/semantics/publishedVersion |
| Format | 77 p., application/pdf |
| Source | TDX (Tesis Doctorals en Xarxa) |
| Rights | L'accés als continguts d'aquesta tesi queda condicionat a l'acceptació de les condicions d'ús establertes per la següent llicència Creative Commons: http://creativecommons.org/licenses/by-nc-nd/3.0/es/, info:eu-repo/semantics/openAccess |
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